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TITERS Protecting your dog with this simple test makes good sense By Don Hamilton DVM Photo: Robert & Patricia Petit After three decades of veterinary practice, I believe vaccination to be a troublesome aspect of medicine. My own observations, along with insights from those who taught me, indicate that vaccination is fraught with misunderstanding. Furthermore, vaccination, in my experience, is likely responsible, at least in part, for the vast majority of chronic disease we see in human and non-human animals in the modern world. For this reason, I do not generally recommend vaccines. However, there is also an inherent risk in not vaccinating. Vaccination does in fact prevent some acute illnesses like parvovirus and distemper virus in dogs and panleukopenia virus in cats. While puppies are at much greater risk than adult animals for contracting infectious diseases, adult animals are not without risk. I have seen unvaccinated adult cats, for example, who became infected with panleukopenia virus, and some of these died. I do not recall seeing canine parvovirus in an adult dog, but it can occur. I have seen canine distemper in an adult dog, although thankfully not a fatal case, so far, in an adult. Vaccination, therefore, has a certain benefit. It 34 May/June 2012 | Dogs Naturally Magazine
is the risk that is less well understood, but my experience is that this risk is high. There are larger questions here, including Darwin’s “survival of the fittest,” which implies that diseases are in fact strengthening factors for species. If we view the species as that which must be kept alive rather than the individual, then we must not vaccinate. However, it is not so simple to ignore the individual, and in this case, many animal guardians choose to vaccinate. As I understand, though, vaccination protects against the acute illness by inducing a chronic one in its stead. The more vaccinations we give (or receive), generally the greater the impact of the chronic disease. Today, many animal caregivers recognize the basis of this danger of over-vaccination, and many will choose not to vaccinate except as required by law, preferring the risk of exposure to that of vaccine induced disease. Others, however, choose not to risk infection, preferring to vaccinate as wisely as possible. For those guardians, we look for ways to minimize the damage while maximizing the protection. Titer testing is one way to do this. A titer is a measurement of the amount of antibody in serum to a given antigen. An antigen is a substance that can induce an immune response, and usually refers to inducing antibody production. Proteins and other substances on bacterial and viral outer surfaces, for example, induce antibody production following infection or vaccination. Antibodies are proteins that the body produces to help fight infections; these bind to foreign antigens, facilitating their destruction and removal from the body. Antibodies are also called immunoglobulins. greater. This will depend upon the laboratory performing the test, however, so any result must be compared with that laboratory’s standards. For any of these viral diseases, though, as long as a dog has a titer with the second number equal to or higher than that of the lab’s protective titer, you can rest assured that he or she is protected. Now, however, this brings a second question, and that is, does an animal have to maintain such a titer to remain protected? The short answer is no. However, in response to client requests (or due to their own knowledge), many progressive veterinarians now offer titer testing in lieu of routine vaccination. The idea is that, perhaps three years after the last vaccine, the veterinarian would take a blood sample and test a dog for parvo or distemper. Should one of these titers fall below the protective level, then the veterinarian would recommend a booster vaccine. While this is a great step forward from routine boosters, and especially from annual routine boosters, it is mostly unnecessary. Immunological science informs us that, once an animal has a protective antibody level, as indicated by a protective titer, that animal is almost certainly protected for life, at least for the major diseases (parvo, distemper and canine hepatitis virus). Thus, once you run a titer test that indicates a protective level, you need Titer testing involves using a known antigen (such as canine distemper virus) and mixing this with serum to see if the serum contains antibodies that will bind to the antigen. This binding is called agglutination. If agglutination occurs, then the laboratory technician will dilute the serum and repeat the test. This step is repeated until the serum is diluted to the point that agglutination no longer occurs. The last dilution at which agglutination happens is then said to be the titer against distemper, for example. Historically, titer testing was done at two-fold dilutions, in the sequence 2, 4, 8, 16, and so on. The resultant titer would then be represented as a ratio, such as 1:16 or 1:32, meaning that agglutination still occurred when the serum was diluted to 1/16 or 1/32 of full strength. The higher the second number, the more dilute the serum could be and still agglutinate the antigen, therefore the more antibody was present in the serum and the greater the protection. In practice, there is generally a recognized minimum titer that provides adequate protection, and anything over that is gravy, so to speak. Additionally, today the titers are tested more mathematically, so the older two-fold dilution is not always how titers are reported. For example, protective titers for canine distemper virus (CDV), canine parvovirus (CPV) are generally 1:5 or Dogs Naturally Magazine | May/June2012 35
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